Hospital consultants seek increased funding and staffing

Minister for Public Expenditure and Reform Brendan Howlin who said health spending by the Government has remained almost unchanged since 2011, and was down just €19 million. Photograph: Cyril Byrne/The Irish Times

Repeated reductions in hospital and mental health budgets over the past 5 years have undermined the delivery of frontline services, hospital consultants have argued.

In a pre-Budget submission published today (THURS), the Irish Hospital Consultants Association (IHCA) said there was a pressing need to increase frontline acute hospital resources in the 2015 Budget “otherwise the delivery of care to patients will be adversely affected leading to increased delays and growing numbers of patients on waiting lists”.

The IHCA also called for increased frontline staffing in hospital and mental health services as well as for the restoration of the level of tax relief on health insurance subscriptions that was in place prior to the Budget last October.

It also urged that the 30 per cent cut in salaries for new entrant hospital consultants put in place by the Government in 2012 be reversed.

The IHCA said the total health budget provisions for acute hospitals and mental health services had been cut excessively during the past five years of austerity.

It contended that recent health budgets had not been based on realistic estimates of patient demand.

The IHCA said it was “essential that increased funding for these frontline services is provided in the 2015 Budget, especially as the country’s economic circumstances continue to improve”.

The IHCA submission said:

*there is insufficient funding to enable the delivery of safe, high quality acute hospital and mental health services taking account of increased demand for care

*there are inadequate frontline recourses which is preventing the optimum use of existing bed, theatre and other facilities

* health services management have failed to recruit and retain the required number of hospital consultants to provide care to patients without delays

IHCA president Dr Gerard Crotty said he was concerned that budgets for acute hospitals had been cut to unrealistic levels with the result that in the first five months of 2014, acute hospital expenditure was €104.8 million over-budget.

The vast majority of hospitals are grossly underfunded with some overspending by up to 21 per cent . Funding for acute hospital services has been cut by almost one fifth compared with the resources in place in 2008.

If increased resources are not provided in the 2015 Budget it will increase the risk that a growing number of patients will not be treated within a medically appropriate timeframe.”

“Alarmingly, there were 50,689 patients awaiting elective care in May 2014 representing a 5 per cent increase on May 2013. It is clear that the deep acute hospital budget cuts have increased the number of patients awaiting treatment and it is essential that hospital budgets are based on more realistic estimates of projected demand.

The association strongly recommends that increased resources are provided in Budget 2015 in order to utilise the existing bed and theatre capacity to the optimum.”

The IHCA’s calls for increased health resources came just hours after the Minister for Public Expenditure and Reform Brendan Howlin argued there had in fact been little or no reduction in Government health spending over the past three years when additional supplementary provided money was taken into account.

In a blog on his website he wrote: “Health expenditure has remained relatively constant over the past three years. This reflects the protection of hospital and PCRS (primary and community care) expenditure. In 2011 gross Health Service Executive expenditure stood at €13.9 billion. By 2013, this figure stood at €13.88 billion, a decrease of only€19 million or 0.13 per cent.

Importantly, these are outturn figures and include supplementary estimates passed by the Dáil each year.